JACOB THOMAS BROWNBACK (NPI# 1154757078) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154757078 |
| Entity Type | Individual |
| Full Name | JACOB THOMAS BROWNBACK |
| Practice Address |
4628 Lafayette Ave Kansas City KS 66104 |
| Mailing Address |
4628 Lafayette Ave Kansas City KS 66104-3335 |
| Practice Telephone | 9133029317 |
| Mailing Telephone | 9133029317 |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2013-09-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 2012021520 | MO | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NATA BOARD OF CERTIFICATION | 2000010702 | 01 |
| Street Address |
4628 LAFAYETTE AVE |
| City | KANSAS CITY |
| State | KS |
| Zip Code | 66104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649238221 | Vishal K Adma | Psychiatry & Neurology | 4300 Brenner Drive, Kansas City, KS 66104 | 2006-05-03 |
| 1629049929 | Josetta Eliese Wahwassuck | Nurse Practitioner | 4300 Brenner Dr, Kvc Prairie Ridge Hospital, Kansas City, KS 66104 | 2006-01-27 |
| 1093191017 | Kvc Hospitals Inc | Psychiatric Hospital | 4300 Brenner Drive, Kansas City, KS 66104 | 2015-07-31 |
| 1578876801 | Sadiq Naveed | Psychiatry & Neurology | 4300 Brenner Dr, Kansas City, KS 66104 | 2010-07-15 |
| 1750397733 | Joyce E Dorssom | Nurse Practitioner | 8919 Parallel Parkway, Suite 555, Kansas City, KS 66104 | 2006-07-31 |
| 1497125470 | Prescription Management Associates | Pharmacy | 4300 Brenner Dr Ste 200, Kansas City, KS 66104-1163 | 2015-10-02 |
| 1205484219 | Sarah Diane Kassin | Nurse Practitioner | 4300 Brenner Dr, Kansas City, KS 66104-1163 | 2019-09-03 |
| 1881197986 | Tricia Lea Felin | Nurse Practitioner | 4300 Brenner Dr, Kansas City, KS 66104-1163 | 2018-03-14 |
| 1639696743 | Jessica Collins Fairchilds | Nurse Practitioner | 4300 Brenner Dr, Kansas City, KS 66104-1163 | 2017-08-29 |
| 1275070724 | Kvc Hospital Inc | General Practice | 4300 Brenner Dr, Kansas City, KS 66104-1163 | 2017-01-23 |
| Find all providers in zip 66104 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750993093 | Alyssa Brown | Student in an Organized Health Care Education/Training Program | 1444 Grand Blvd Apt 1201, Kansas City, MO 64106-2975 | 2020-08-18 |
| 1093330599 | Tarek Haidar | Student in an Organized Health Care Education/Training Program | Research Medical Center / Goppert Family Medicine, 6675 Holmes Road, Ste 450, Kansas City, MO 64131 | 2020-06-10 |
| 1174142640 | John Price | Student in an Organized Health Care Education/Training Program | 12806 Lathrop Ave, Kansas City, KS 66109-1003 | 2020-04-14 |
| 1104454396 | Bryan Clements | Student in an Organized Health Care Education/Training Program | 3940 Genessee St, Kansas City, MO 64111-4105 | 2020-04-01 |
| 1699302729 | Molly Bliss | Student in an Organized Health Care Education/Training Program | 3901 Rainbow Blvd # Ms 4034, Kansas City, KS 66160-8500 | 2020-03-26 |
| 1205467578 | Tina Thanh Thuy Tran | Student in an Organized Health Care Education/Training Program | 5100 Grand Ave, Kansas City, MO 64112-2739 | 2020-01-27 |
| 1124659495 | Danni Gray | Student in an Organized Health Care Education/Training Program | 806 E 110th Ter, Kansas City, MO 64131-3543 | 2020-01-27 |
| 1841821113 | Shannon Rebecca Pulliam | Student in an Organized Health Care Education/Training Program | 3012 Charlotte St, Kansas City, MO 64109-1422 | 2020-01-27 |
| 1578194841 | Michael Peter Schooley | Student in an Organized Health Care Education/Training Program | 5414 N Mercier Ave, Kansas City, MO 64118-7821 | 2020-01-27 |
| 1023649399 | Jessica Hartzler | Student in an Organized Health Care Education/Training Program | 25 E 12th St Apt 1102, Kansas City, MO 64106-2342 | 2020-01-27 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 66104 |
Please comment or provide details below to improve the information on JACOB THOMAS BROWNBACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.